Provider Demographics
NPI:1538829288
Name:MEDICAL SERVICES GROUP PLC
Entity type:Organization
Organization Name:MEDICAL SERVICES GROUP PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-805-6055
Mailing Address - Street 1:11774 ROSEMARY ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48213-1349
Mailing Address - Country:US
Mailing Address - Phone:313-340-2655
Mailing Address - Fax:313-340-2666
Practice Address - Street 1:22341 W 8 MILE RD STE 4
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-1217
Practice Address - Country:US
Practice Address - Phone:313-340-2655
Practice Address - Fax:313-340-2666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty